SECONDREGULARSESSION HOUSEBILLNO.2371 101STGENERALASSEMBLY INTRODUCEDBYREPRESENTATIVESMITH(155). 5138H.01I DANARADEMANMILLER,ChiefClerk ANACT Torepealsections197.400,197.405,and197.445,RSMo,andtoenactinlieuthereofthree newsectionsrelatingtohomehealth. BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: SectionA.Sections197.400,197.405,and197.445,RSMo,arerepealedandthree 2newsectionsenactedinlieuthereof,tobeknownassections197.400,197.405,and197.445, 3toreadasfollows: 197.400.Asusedinsections197.400to197.475,unlessthecontextotherwise 2requires,thefollowingtermsmean: 3 (1)"Clinicalnursespecialist",apersonlicensedbythestateboardofnursing 4undertheprovisionsofchapter335topracticeinthisstateasaclinicalnursespecialist; 5 (2)"Council",thehomehealthservicesadvisorycouncilcreatedbysections197.400 6to197.475; 7 [(2)](3)"Department",thedepartmentofhealthandseniorservices; 8 [(3)](4)"Homehealthagency",apublicagencyorprivateorganizationora 9subdivisionorsubunitofanagencyororganizationthatprovidestwoormorehomehealth 10servicesattheresidenceofapatientaccordingtoa[physician's] written[andsigned] planof 11treatmentsignedbyaphysician,podiatrist,nursepractitioner,clinicalnursespecialist, 12orphysicianassistant; 13 [(4)](5)"Homehealthservices",anyofthefollowingitemsandservicesprovidedat 14theresidenceofthepatientonapart-timeorintermittentbasis:nursing,physicaltherapy, 15speechtherapy,occupationaltherapy,homehealthaid,ormedicalsocialservice; EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 16 [(5)](6)"Nursepractitioner",apersonlicensedbythestateboardofnursing 17undertheprovisionsofchapter335topracticeinthisstateasanursepractitioner; 18 (7)"Part-timeorintermittentbasis",theprovidingofhomehealthservicesinan 19interruptedintervalsequenceontheaverageofnottoexceedthreehoursinanytwenty-four- 20hourperiod; 21 [(6)](8)"Patient'sresidence",theactualplaceofresidenceofthepersonreceiving 22homehealthservices,includinginstitutionalresidencesaswellasindividualdwellingunits; 23 [(7)](9)"Physician",apersonlicensedbythestateboardofregistrationforthe 24healingartspursuanttotheprovisionsofchapter334topracticeinthisstateasaphysician 25andsurgeon; 26 [(8)](10)"Physicianassistant",apersonlicensedbythestateboardof 27registrationforthehealingartsundertheprovisionsofchapter334topracticeinthis 28stateasaphysicianassistant; 29 (11)"Planoftreatment",aplanreviewedandsignedasoftenasmedicallynecessary 30byaphysician[or],podiatrist,nursepractitioner,clinicalnursespecialist,orphysician 31assistant,nottoexceedsixtydaysinduration,prescribingitemsandservicesforan 32individualpatient'scondition; 33 [(9)](12)"Podiatrist",apersonlicensedbythestateboardofpodiatrypursuanttothe 34provisionsofchapter330topracticeinthisstateasapodiatrist; 35 [(10)] (13)"Subunit"or"subdivision",anyorganizationalunitofalarger 36organizationwhichcanbeclearlydefinedasaseparateentitywithinthelargerstructure, 37whichcanmeetalloftherequirementsofsections197.400to197.475independentofthe 38largerorganization,whichcanbeheldaccountableforthecareofpatientsitisserving,and 39whichprovidestoallpatientscareandservicesmeetingthestandardsandrequirementsof 40sections197.400to197.475. 197.405.Nohomehealthagency,includingMedicareandMedicaidproviders,shall 2providetwoormoreofthehomehealthservicescoveredbysubdivision[(4)](5)ofsection 3197.400orshallholditselfoutasprovidingsuchhomehealthservicesorasahomehealth 4agencyunlessitislicensedandregisteredinaccordancewiththeprovisionsofsections 5197.400to197.475. 197.445.1.Thedepartmentmayadoptreasonablerulesandstandardsnecessaryto 2carryouttheprovisionsofsections197.400to197.477.Therulesandstandardsadopted 3shallnotbelessthanthestandardsestablishedbythefederalgovernmentforhomehealth 4agenciesunderTitleXVIIIoftheFederalSocialSecurityAct.Thereasonablerulesand 5standardsshallbeinitiallypromulgatedwithinoneyearofSeptember28,1983. 6 2.Therulesandstandardsadoptedbythedepartmentpursuanttotheprovisionsof 7sections197.400to197.477shallapplytoallhealthservicescoveredbysections197.400to HB2371 2 8197.477renderedtoanypatientbeingservedbyahomehealthagencyregardlessofsourceof 9paymentfortheservice,patient'scondition,orplaceofresidence,atwhichthehomehealth 10servicesareorderedbythephysician[or],podiatrist, nursepractitioner,clinicalnurse 11specialist,orphysicianassistant. Noruleorportionofarulepromulgatedpursuanttothe 12authorityofsections197.400to197.477shallbecomeeffectiveunlessithasbeen 13promulgatedpursuanttotheprovisionsofsection536.024. ✔ HB2371 3